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General NPI Number Information
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NPI Number | 1043666209
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Entity Type | Organization
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Legal Business Name | ACCULAB GROUP LLC
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Dates
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Enumeration Date | 05/06/2016
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Last Update Date | 05/06/2016
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Provider Practice Location Address
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Address Line | 1919 OAKWELL FARMS PKWY SUITE 160
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City | SAN ANTONIO
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State | TX
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Zip | 78218-1777
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Country | US
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Telephone | 210-254-0891
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Fax |
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Provider Business Mailing Address
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Address Line | 1919 OAKWELL FARMS PKWY SUITE 250
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City | SAN ANTONIO
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State | TX
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Zip | 78218-1777
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CONSULTANT
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Name | JOHN BARKER
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Credential |
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Telephone | 210-254-0891
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 45D2111937
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License Number State | TX
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